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General NPI Number Information
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NPI Number | 1417594086
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Entity Type | Organization
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Legal Business Name | BARBARA HANNAH
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 11800 N 300 W
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City | ALEXANDRIA
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State | IN
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Zip | 46001-8689
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Country | US
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Telephone | 765-620-3536
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Fax |
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Provider Business Mailing Address
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Address Line | 11800 N 300 W
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City | ALEXANDRIA
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State | IN
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Zip | 46001-8689
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Country | US
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Telephone | 765-620-3536
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BARBARA S HANNAH
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Credential | NURSE PRACTITIONER
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Telephone | 765-620-3536
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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